Predicting adverse outcomes in dilated cardiomyopathy using 3D echocardiography: penalised Cox regression versus machine learning

In this DCM cohort, ML models, particularly RF, maximised discrimination but exhibited calibration issues. A penalised regression model (Lasso-Cox) provided the best overall trade-off between discrimination, calibration, and interpretability, and is therefore recommended as the preferred approach for clinical risk stratification and future public health-oriented implementation studies in DCM.